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Biceps Tendinopathy

Painful overuse degeneration or inflammation of the long head of biceps tendon in the bicipital groove producing anterior shoulder pain worsened by activities involving forward elevation and supination.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Biceps Tendinopathy?

Biceps tendinopathy encompasses a spectrum of degenerative and inflammatory disorders affecting the long head of biceps brachii tendon as it traverses the bicipital groove from origin at supraglenoid tubercle through the rotator interval; commonly coexists with rotator cuff pathology in 90% of cases.

Pathophysiology includes mechanical impingement under coracoacromial arch (subacromial impingement), repetitive microtrauma in overhead athletes (swimmers, throwers), instability with subluxation in the bicipital groove, and SLAP (superior labrum anterior posterior) tears with biceps anchor disruption.

Classification — primary tendinitis (rare, isolated inflammation), secondary tendinitis (associated with rotator cuff or impingement), tendinosis (chronic degenerative changes), instability or subluxation, and rupture; clinical evaluation combines provocative tests with ultrasound or MRI imaging.

Symptoms

Anterior shoulder pain over bicipital groove
Pain with overhead activities and lifting
Pain with resisted elbow flexion (Yergason test)
Pain with resisted forearm supination (Speed test)
Tenderness in bicipital groove with arm internally rotated 10 degrees
Popeye deformity if rupture occurs
Snapping or clicking with subluxation

Risk Factors

Rotator cuff pathology (90% coexisting)
Subacromial impingement syndrome
Repetitive overhead activities (sports, work)
Age over 40 years (degenerative tendinosis)
Heavy lifting and weight training
SLAP lesions and labral tears
Throwing athletes (baseball pitchers, javelin throwers)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent anterior shoulder pain >2-4 weeks
  • Pain interfering with sleep or activities
  • Sudden onset pain with snapping (rupture concern)
  • Failed home rest and NSAIDs
  • Athletic performance limitation
  • Suspected rotator cuff or labral involvement
  • Recurrent symptoms despite treatment

Treatment Methods

01
Activity modification — avoid overhead and heavy lifting
02
NSAIDs and ice for inflammation
03
Physical therapy — eccentric strengthening, posterior capsule stretching, scapular stabilization
04
Corticosteroid injection into bicipital sheath under ultrasound guidance
05
PRP (platelet-rich plasma) injection for chronic tendinosis
06
Arthroscopic tenodesis (suprapectoral or subpectoral) for refractory or unstable cases
07
Tenotomy in older lower-demand patients (cosmetic Popeye deformity acceptable)

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.